Surgical anatomy of the round window—Implications for cochlear implantation

Lüers, Jan-Christoffer; Hüttenbrink, K.-B.; Beutner, Dirk

doi:10.1111/coa.13048

Cited by 26 publications

(25 citation statements)

References 56 publications

(238 reference statements)

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“…In light of this limitation, specifically volume averaging, we are more precisely, attempting to establish the orientation of the fibrous annulus of the RWM as a surrogate for membrane orientation. The fibrous ring orientation is unlikely to shift postmortem, as it is attached to the adjacent bone of the Round Window Niche (Luers, Huttenbrink, & Beutner, ). As the intent is to ultimately provide a vector for driving therapeutic nanoparticles into the inner ear, in vivo 3D orientation of the thin RWM itself is not as relevant as the net orientation vector.…”

Section: Resultsmentioning

confidence: 99%

Orientation of the round window membrane: A normative study of inner ear anatomical orientation using 2D projections of 3D volumes

Rutel

Stoner

Kota

et al. 2019

The Anatomical Record

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Introduction: Orientation of the Round Window Membrane (RWM) is an important metric to establish if utilized as a potential access for targeted delivery of magnetically guided nanomedicines to the inner ear. Orientation with respect to an internal reference frame (such as the planes defined by the semicircular-canals [SCC]) may provide an internally consistent basis if the basis is orthogonal and consistent (from patient to patient). Materials and Methods: Utilizing a micro computed tomography (CT), 20 temporal bones are scanned for anatomical information. The scanned data sets are loaded into an imaging program to provide volumetric reconstruction and segmentation. Volumetric models of the anatomical relationships between the inner ear SCC and the RWM are utilized to get normative projection angle information and are statistically analyzed. Results: Micro-CT shows low to moderate reliability for reproducibility, intraobserver, and interobserver measurements; in addition, it provides mean values (±SD) for the various measured angles. The combined mean angular values for surface orientation of the RWM, with respect to the SCC basis (quasi-orthogonal spherical coordinate system), was 57.0 ± 20.9 as measured from the line defining the posterior SCC plane in the direction of the line defining the superior SCC plane. An angle of 65.2 ± 19.1 was measured for an angle away from the line defining the horizontal SCC plane.

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Section: Resultsmentioning

confidence: 99%

Orientation of the round window membrane: A normative study of inner ear anatomical orientation using 2D projections of 3D volumes

Rutel

Stoner

Kota

et al. 2019

The Anatomical Record

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“…Contained within the connective tissue layer are elastic fibres, collagen, and fibroblasts in addition to lymph and blood vessels [ 102 ]. The permeability of the RWM depends on the size, surface charge, hydrophilicity, RWM thickness, and total contact time with the RWM [ 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ]. Clearance of the middle ear via the Eustachian tube is another concept to consider when designing an inner ear drug delivery system.…”

Section: The Existing Barriers In Effective Treatment Of Age-related Hearing Lossmentioning

confidence: 99%

“…The thickness of the RWM is variable between individuals to some degree but is significantly increased in those with otitis media, thus decreasing its permeability [ 103 , 104 , 105 ]. With regard to size, smaller particles show greater permeability to the RWM than larger particles in a study comparing three nanocarriers of varying size.…”

Section: Local Drug Delivery Of Antioxidants To Inner Earmentioning

confidence: 99%

A Review on Recent Advancement on Age-Related Hearing Loss: The Applications of Nanotechnology, Drug Pharmacology, and Biotechnology

et al. 2021

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Aging is considered a contributing factor to many diseases such as cardiovascular disease, Alzheimer’s disease, and hearing loss. Age-related hearing loss, also termed presbycusis, is one of the most common sensory impairments worldwide, affecting one in five people over 50 years of age, and this prevalence is growing annually. Associations have emerged between presbycusis and detrimental health outcomes, including social isolation and mental health. It remains largely untreatable apart from hearing aids, and with no globally established prevention strategies in the clinical setting. Hence, this review aims to explore the pathophysiology of presbycusis and potential therapies, based on a recent advancement in bile acid-based bio-nanotechnologies. A comprehensive online search was carried out using the following keywords: presbycusis, drugs, hearing loss, bile acids, nanotechnology, and more than 150 publications were considered directly relevant. Evidence of the multifaceted oxidative stress and chronic inflammation involvement in cellular damage and apoptosis that is associated with a loss of hair cells, damaged and inflamed stria vascularis, and neuronal signalling loss and apoptosis continues to emerge. New robust and effective therapies require drug delivery deeper into the various layers of the cochlea. Bile acid-based nanotechnology has gained wide interest in its permeation-enhancing ability and potential for numerous applications in treating presbycusis.

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“…Factors that influence the optimal trajectory for atraumatic electrode insertion include the orientation and size of the cochlear basal turn, and the anatomy of the hook region that lies immediately behind the round window membrane. 7 Several aspects of round window anatomy are relevant to its use as a portal for electrode insertion. Certain anatomical features in fact suggest that the round window is not the ideal portal for cochlear implantation.…”

Section: B Jun S Songmentioning

confidence: 99%

Surgical considerations during cochlear implantation: the utility of temporal bone computed tomography

Jun

Song

2021

J. Laryngol. Otol.

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Objective This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography. Methods Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion. Results Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach. Conclusion It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.

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Surgical anatomy of the round window—Implications for cochlear implantation

Cited by 26 publications

References 56 publications

Orientation of the round window membrane: A normative study of inner ear anatomical orientation using 2D projections of 3D volumes

Orientation of the round window membrane: A normative study of inner ear anatomical orientation using 2D projections of 3D volumes

A Review on Recent Advancement on Age-Related Hearing Loss: The Applications of Nanotechnology, Drug Pharmacology, and Biotechnology

Surgical considerations during cochlear implantation: the utility of temporal bone computed tomography

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